Heterogeneous Microscopic Dynamics of Intruded Water in a Superhydrophobic Nanoconfinement: Neutron Scattering and Molecular Modeling.

With their strong confining porosity and versatile surface chemistry, zeolitic imidazolate frameworks-including the prototypical ZIF-8-display exceptional properties for various applications. In particular, the forced intrusion of water at high pressure (∼25 MPa) into ZIF-8 nanopores is of interest for energy storage. Such a system reveals also ideal to study experimentally water dynamics and thermodynamics in an ultrahydrophobic confinement. Here, we report on neutron scattering experiments to probe the molecular dynamics of water within ZIF-8 nanopores under high pressure up to 38 MPa. In addition to an overall confinement-induced slowing down, we provide evidence for strong dynamical heterogeneities with different underlying molecular dynamics. Using complementary molecular simulations, these heterogeneities are found to correspond to different microscopic mechanisms inherent to vicinal molecules located in strongly adsorbing sites (ligands) and other molecules nanoconfined in the cavity center. These findings unveil a complex microscopic dynamics, which results from the combination of surface residence times and exchanges between the cavity surface and center.

Seguridad en procedimientos dermatológicos: crisis hipertensiva y arritmias potencialmente malignas / Safety in Dermatologic Procedures: Hypertensive Crises and Potentially Fatal Arrhythmias

Es importante para el cirujano dermatológico, que en muchas ocasiones realiza cirugías prolongadas con el uso exclusivo de anestesia local, conocer el manejo básico de 2complicaciones potencialmente graves: las crisis hipertensivas y las arritmias intraoperatorias. Respecto a las crisis hipertensivas, diferenciamos entre urgencia hipertensiva: elevación importante de la presión arterial (>180/110mm) sin disfunción de órgano diana y urgencia hipertensiva: presión arterial>180/110mmHg con daño progresivo de órgano diana y que requiere de su reducción inmediata. En la primera el objetivo será disminuir esa presión en días y no suele requerir tratamiento urgente, mientras que en la urgencia hipertensiva no se recomienda reducirla excesivamente rápido para evitar daño isquémico en lechos vasculares adaptados a una presión arterial elevada. De elección para el dermatólogo por su perfil de seguridad y sencillez en la urgencia hipertensiva es el captopril. En cuanto a las arritmias: la bradicardia asintomática no precisará de tratamiento, pero siempre comprobaremos que el paciente se encuentra alerta y orientado. En el caso de las taquicardias en las que el paciente esté estable, el siguiente paso sería medir la anchura del complejo QRS y, si esté es ancho, avisar al anestesista. Se recomienda conocer los fármacos disponibles en el quirófano, tenerlos en lugar accesible y elegir los imprescindibles para conocer su uso y dosis. Idealmente, conviene monitorizar y tener preparada la toma de vía periférica en todas las intervenciones en quirófano, así como conocer a todo el personal de quirófano y la localización del especialista en anestesia y reanimación (AU)

As dermatologic surgeons often have to perform long surgeries with local anesthetic only, they should be familiar with the fundamentals of how to manage 2 potentially serious complications: Hypertensive crises and intraoperative arrhythmias. Hypertensive crises can be classified as 1) hypertensive urgencies, characterized by a significant spike in blood pressure (>180/110mmHg) without target-organ dysfunction or 2) hypertensive emergencies, characterized by a blood pressure above 180/110mmHg with progressive target-organ damage. In emergencies, the blood pressure needs to be reduced immediately whereas in urgencies the goal is to reduce it over several days. Care must still be taken not to reduce the blood pressure excessively rapidly in emergencies, however, to avoid ischemic injury to vascular beds that have adapted to a high blood pressure. We recommend that dermatologic surgeons use captopril in hypertensive emergencies because of its safety profile and ease of use. Asymptomatic intraoperative bradycardia does not require treatment, but patients should always be checked to ensure they are alert and responsive. The first step in clinically stable patients with tachycardia is to measure the width of the QRS complex and notify the anesthetist when this is wide. Dermatologic surgeons should also be familiar with the drugs available in the operating room, ensure that they are easily accessible, and identify the most essential ones so they can familiarize themselves with indications and dosage. Patients should be monitored throughout the operation, and material to secure a peripheral intravenous line should be prepared in case of need. Finally, the dermatologic surgeon should know all the staff working in the operating room and be able to locate the specialist in anesthesia and resuscitation (AU)

Optimised room temperature, water-based synthesis of CPO-27-M metal-organic frameworks with high space-time yields.

The exceptional porosity of Metal-Organic Frameworks (MOFs) could be harnessed for countless practical applications. However, one of the challenges currently precluding the industrial exploitation of these materials is a lack of green methods for their synthesis. Since green synthetic methods obviate the use of organic solvents, they are expected to reduce the production costs, safety hazards and environmental impact typically associated with MOF fabrication. Herein we describe the stepwise optimisation of reaction parameters (pH, reagent concentrations and reaction time) for the room temperature, water-based synthesis of several members of the CPO-27/MOF-74-M series of MOFs, including ones made from Mg(II), Ni(II), Co(II) and Zn(II) ions. Using this method, we built MOFs with excellent BET surface areas and unprecedented Space-Time Yields (STYs). Employing this approach, we have synthesised CPO-27-M MOFs with record BET surface areas, including 1279 m2 g-1 (CPO-27-Zn), 1351 m2 g-1 (CPO-27-Ni), 1572 m2 g-1 (CPO-27-Co), and 1603 m2 g-1 (CPO-27-Mg). We anticipate that our method could be applied to produce CPO-27-Ni, -Mg, -Co and -Zn with STYs of 44 Kg m-3 day-1, 191 Kg m-3 day-1, 1462 Kg m-3 day-1 and a record 18720 Kg m-3 day-1, respectively.

Poor bisphosphonate adherence for treatment of osteoporosis increases fracture risk: systematic review and meta-analysis.

UNLABELLED: Systematic review of adherence to bisphosphonates for the treatment of osteoporosis finds suboptimal levels of persistence and compliance. Poor bisphosphonate compliance increases fracture risk. INTRODUCTION: The objectives of the study were to measure the persistence and compliance with bisphosphonates for the treatment of osteoporotic patients, and to estimate the influence of compliance on fracture risk. METHODS: A systematic review of bisphosphonate adherence in clinical practise provided new evidence to perform a meta-analysis of the means of bisphosphonate persistence and compliance, with a subsequent meta-analysis of fracture risk comparing poorly versus highly compliant patients. RESULTS: Fifteen articles, totalling 704,134 patients, met our inclusion criteria. Most of the patients were postmenopausal women treated with bisphosphonates. The 3.95% of the patients received hormone replacement therapy, but the rest received bisphosphonates. The meta-analysis of five articles totalling 236,540 patients, who were followed for 1 year, provided a pooled persistence mean of 184.09 days. The meta-analysis of five articles, totalling 234,737 patients, who were also followed for 1 year, provided a pooled medication possession ratio mean of 66.93%. The meta-analysis of six articles, totalling 171,063 patients, who were followed for varying periods of time between 1 and 2.5 years, provided a pooled 46% increased fracture risk in non-compliant patients versus compliant patients. The increased fracture risk was lower for non-vertebral (16%) and hip (28%) than for clinical vertebral fractures (43%). CONCLUSIONS: Persistence and compliance are suboptimal for postmenopausal women undergoing bisphosphonate therapy for osteoporosis. The clinical consequence of this low compliance is an increased risk of fracture, which is lower for non-vertebral than for clinical vertebral fractures.

Structural filiations in the new complex titanates SrLiMTi4O11 (M=Cr, Fe).

Two new titanates of strontium, lithium and a 3d metal, with the composition SrLiMTi4O11 (M=Cr, Fe), have been discovered. Single crystals were obtained by spontaneous crystallization from a high-temperature solution with LiBO2 as the solvent. The structure of SrLiCrTi4O11 was refined in the orthorhombic space group Pnma (Z=4), while SrLiFeTi4O11 appeared to adopt a four-times larger orthorhombic unit cell with Pbcn (Z=16). The structures can be described by a close-packed arrangement of Sr and O atoms. The unit cell contains six ;compact planes' perpendicular to [100] in the layer sequence ABACBC [(chc)2]. Ti and Cr or Fe atoms occupy some of the interstitial octahedral sites created, whereas Li atoms are in tetrahedral sites. Depending on the synthesis conditions of SrLiCrTi4O11, the distribution of Cr and Ti atoms on the four possible crystallographic sites is not the same. Having a similar compact-planes sequence, SrLiCrTi4O11 and SrLiFeTi4O11 structures differ in the arrangement of Sr and O atoms per layer of close packing, which also induces a correlated variation in the Li-tetrahedra distribution.

Usefulness of MRI in detecting occult breast cancer associated with Paget's disease of the nipple-areolar complex.

MRI allows for the detection of mammographically and clinically occult breast neoplasms. We analysed the ability of MRI to detect occult breast cancer in three patients with Paget's disease of the nipple-areolar complex, proven histologically. In all three cases we observed differences in the morphological and dynamic features of healthy and pathological nipples, and we also found enhancement foci in breast tissue, with suspicious kinetic and morphological characteristics, which in the case of two patients corresponded to ductal carcinoma in situ. The detection and location with MRI of underlying neoplastic foci may be of help in choosing the most reasonable and conservative treatment in these patients.

[Analysis of the scales of measures, the efficacy of the treatments and the health/social impact of Alzheimer disease in the Basque Country, Spain]. / Análisis de las escalas de medición, eficacia de los tratamientos e impacto sociosanitario de la enfermedad de Alzheimer en el País Vasco.

BACKGROUND: The purpose of this study is to review the clinical analyses regarding efficacy of the different drugs used in the treatment of Alzheimer, across distinct scales of measures in order out the progression of the Alzheimer's Disease (AD). Along with this an economic analysis of the health/social impact of this illness in the Basque Country has been carried out. METHODS: A selection and synthesis of the relevant scientific evidence was made by means of a bibliographical research in the main data bases (Medline, Embase, Cross, Iowa Drug Information System, Healthstar and The Cochrane Library). The value of the costs was carried out from a social perspective. During 1998 a health social costs analysis of this pathology was undertaken in the Basque Country, Spain, starting from a table of assumptions. RESULTS: ADAS and PDS are the only cognitive and functional scales developed and validated specifically for the AD. The drugs specifically prescribed for the AD (tacrine, donepezil, and revastigmine) contribute a slight benefit, whose clinical meaning is unknown. During 1998 the global cost of treating the AD in the Basque Country has been at least 55,858 million pesetas (US$ 360.5 millions dollars). The social cost (nursing homes, day centres, home help, help from family and friends) comes to represent 98.4% of this global cost. CONCLUSIONS: At the moment, there is not any effective drug in the treatment of the AD. The informal cost (help from family and friends) comes to represent 88.4% of the total social costs.

Secondary central nervous system metastases in children with neuroblastoma.

Cerebral and meningeal involvement in patients with primary extracranial neuroblastoma (NB) is unusual although it is generally present in disseminated disease. The intensification of chemotherapy that has prolonged survival in these children has changed the pattern of relapse presentation, as occurs with isolated central nervous system (CNS) disease. We report 4 patients with secondary CNS metastases. Three infants of 16, 14, and 10 months of age, diagnosed with primary abdominal NB stage 4, presented neuromeningeal metastases during maintenance chemotherapy with seizures and cranial hypertension as the first manifestation. Another 8-year-old patient diagnosed with NB stage 3 presented local relapse with later neuromeningeal metastases. All died in the following 3 months. The possibility of CNS relapse in patients with NB should be considered when neurological symptoms and signs appear. These new relapse forms overshadow the prognosis of these children.

Plasma catecholamine and cardiovascular responses to nifedipine in hypertensives WHO-stage II.

77 patients with arterial hypertension were consecutively examined. An evaluable echocardiogram could be recorded for 75 patients. 54 (72%) had non-pathological cardiac findings, 15 (20%) showed concentric left ventricular hypertrophy of the heart (mean left ventricular muscle mass (LVM) 2.5 g/kg or 113 g/m2; mean LVM/EDV 1.6 g/ml). 6 patients had an excentric hypertrophy of the left ventricle (8%). The influence of 10 mg nifedipine (Adalat) sublingual on the heart, blood pressure and sympathetic activity was examined in 15 patients with left ventricular hypertrophy of the heart. 5-10 min after administration, a significant decrease in systolic and diastolic pressures (p less than 0.05) and an increase in plasma noradrenaline (p less than 0.05) and heart rate (p less than 0.01) could be registered. The thickness of the posterior wall and septum decreased in 8 to 10 of the 15 patients, EDV, shortening fraction and ejection fraction increased in 8 of the 15 patients. A reduction in peripheral resistance, sympathetic counterregulation accompanied by an increase in heart rate, shortening and ejection fractions with increased enddiastolic volume and decrease in wall thickness can be observed as the gross effect in the majority of the 15 patients with left ventricular concentric hypertrophy. The decrease in wall thickness as a relaxation effect should not be confused with a regression of hypertrophy, whereby the mass-volume ratio shifts toward the normal range under nifedipine.

[Changes in magnesium levels in surgery of the digestive tract]. / Altérations du magnésium en chirurgie digestive

We studied serum concentrations of magnesium post-operatively in 41 patients divided up into four distinct groups, depending on the degree of seriousness of the operation, the loss of body fluids and the duration of intravenous feeding. The results thus obtained showed us that in digestive disorders there is an initial fall in blood magnesium accentuated in operated patients submitted to continous gastric aspiration or an external biliary drain. In these same patients, there is a tendency to normalisation from the second day after the operation. Only patients with gastric or intestinal fistulas had a curve which fell to the seventh post-operative day reaching severe levels of hypomagnesemia.